Qi&BloodPatternDiagnosisofGynaecologyinTCM妇科气血辨证及方剂整理证型Patterns ClinicalGynecologicalDiseases妇科特征SignsandSymptoms全身证候Tongue舌象 Pulse脉象Herbalformulas常用方剂QiDisorders气证1.QiDeficiency气虚Earlype riod,profuseinamount,paleincolorandthinintexture.flood ingandspotting(崩漏),excesslochia,prolapseoftheuterusandr etentionoftheplacenta(pl??sen(t)?)胎盘)经行先期,量多色淡、质稀,崩漏,恶露不绝,阴挺,胞 衣不下Brightpalecomplexion,shortnessofbreathandreluctanceto speak,listlessness(精神萎靡),lackofstrength,vertigo,blurredvis ion,emptyanddroppingsensationinthelowerabdomen面色光白,气短懒言, 神倦乏力,头晕,目眩,小腹空坠,多污paletonguewiththin,whitetonguecoating舌淡,苔 薄白moderate,weakpulse缓弱辨经或脏腑论治2.QiStagnation气滞Delayedmenstruat ion,spottingorunsmoothflow,dysmenorrhea,amenorrhea(ā?men??r ē?),abdominalmass,anddifficultybreastfeeding经行后期,淋漓不畅,痛经,经闭 ,症瘕,缺乳Chesttightnessanddiscomfort,lowerabdominalandhypocho ndrialdistendingpainonbothsides,migratorypain;abdominalma ss,movableandscatteringwhenpressed胸闷不舒,小腹胀痛连及两胁,痛无定处,或腹部包块, 推之可移,按之可散normaltonguewiththin,whitecoating舌质正常,苔薄白wirypulse 弦肝郁气滞LiverConstraintandqistagnation:柴胡疏肝散chaihushugansan, BloodDisorders血证1.BloodDeficiency血虚Delayedmenstruation,scanty inamount,paleincolorandthinintexture,amenorrhea,dulla bdominalpainaftermenstruation,threatenedmiscarriage(先兆流产或滑胎) ,infertilityandinsufficientbreastmilk.经行后期,量少,色淡、质稀,经闭,经后腹痛, 胎动不安,不孕,缺乳Sallowcomplexion,palefingernails,palelips,drysk in,vertigo,blurryvision,palpitations,lackofsleep,fatigue andlassitude,numbnessoffeetandhands面色萎黄,指甲色淡,唇色淡红,皮肤不润,头晕,眼 花,心悸少寐,疲乏无力,乎足发麻paletonguewithscantytonguecoating舌淡,苔少thread y,forcelesspulse细而无力桃红四物汤taohongsiwutang,归脾汤guipitangbloo ddeficiency+qistagnation血虚气滞之产后腹痛:枳实芍药散2.BloodStasis血瘀Irregul armenstrualcycleswithpurplishbloodandclots,inhibitedflow ofmenstrualblood,dysmenorrhea,amenorrhea,floodingandspott ing(崩漏),abdominalmass,postpartumabdominalpain,difficultdis chargeoflochia(lōkē?恶露)orleukorrhea(lo?ok??rē?白带),retention oftheplacenta(pl??sen(t)?)胎盘)经期不定,色紫有块,经行不畅,痛经,经闭,崩漏,症瘕,产后腹痛,恶露 不下或恶露不绝,胞衣不下Lowerabdominalpainormass,sharpstabbingpainof fixedlocation,worsewithpressureandbetterwithdischargeof clots,dryscalyskin,thirstwithnodesiretodrink小腹疼痛,或有积块,痛处 不移,如针刺状,按之痛甚,血块下后痛减,皮肤干燥,甚则甲错,口干不欲饮darkpurpletonguewithpetech iae[pi`ti:kii:]瘀点atthetongueedge舌紫黯,舌边有紫点或瘀斑deep,choppypuls ewithforce沉涩有力身痛逐瘀汤shentongzhuyutang,血府逐瘀汤xuefuzhuyutan g,桂枝茯苓丸guizhifulingwan,Bloodstasis+constipationinthelowe rJiao下焦蓄血,大便不通:桃核承气汤taohechengqitang,Bloodstasis+heatinth elowerJiao下焦瘀血,热,干血:大黄蛰虫丸dahuangzhechongwan,抵挡汤丸Coldinthe womb,Blooddeficiency,bloodstasis,qistagnation宫寒,血虚,气滞血瘀:少腹逐 瘀汤shaofuzhuyutang,3.BloodHeat血热ExcessHeat:Earlyperiod,he avyflowthatispurple-redincolorandstickyandthickintext ure,floodingandspotting(崩漏),threatenedmiscarriageandleukor rhea(lo?ok??rē?白带)实热:经行先期,月经过多,色紫红、质粘稠,崩漏,胎动不安,恶露不绝Redcomplexion ,drymouth,andfeverwithapreferenceforcolddrink,chestti ghtnessandvexation烦,darkurine,constipation面色红,口干发热,渴喜冷饮,心胸烦 闷,小便黄赤,大便秘结redtonguewithyellowishcoating舌红,苔黄Slipperyorfast ,surgingpulse滑数或洪数辨经或脏腑论治DeficiencyHeat:Earlyperiod,scanty inamountandbrightredincolor,floodingandspotting(崩漏),thre atenedmiscarriage(先兆流产或滑胎)虚热:经行先期,经量少、色鲜红,崩漏,胎动不安Flushedcomplex ion,lowgradeortidalfever,vexingheatinthefivecenters(ch est,palmsandsoles),insomnia,excessivedreams,nightsweats,d rymouthandthroat面色潮红,低热或潮热,五心烦热,少寐多梦,盗汗,口燥咽干redtonguewithl ittleornotonguecoating舌红,苔少或无苔thready,fast,forcelesspulse细 数无力辨经或脏腑论治4.BloodCold血寒ExcessCold:Delayedmenstruation,scanty inamountandredincolor,floodingandspotting(崩漏),threatene dmiscarriage(先兆流产或滑胎).实寒:经行后期,量少、色鲜红,崩漏,胎动不安Colickypain(绞痛)in thelowerabdomen,slightlyrelievedbyheat,grey-whitecomplexio n,coldlimbs小腹绞痛,得热稍减,面色青白,形寒肢冷darktonguewithwhitecoating舌黯 ,苔白deep,tightpulse沉紧温经汤wenjingtangblooddeficiency,cold,qis tagnation,bloodstasis血虚寒凝,气滞血瘀:桔荔散结丸julisanjiewanDeficiency Cold:Delayedmenstruation,scantyinamountandlightredincolo rwithdysmenorrhea虚寒:经行后期,量少、色淡,痛经Continuousabdominalpainreli evedbywarmthandpressure,vertigo,shortnessofbreath,aching andweaklowerback腹痛绵绵,喜暖喜按,头晕短气,腰酸无力paletonguewithwhitem oistcoating舌淡,苔白润deep,slow,forcelesspulse沉迟无力桃红四物汤taohongsi wutang乌鸡白凤丸wujibaifengwan艾附暖宫丸aifunuangongwan或辨经或脏腑论治Za ng-FuPatternDiagnosisofGynaecologyinTCM妇科脏腑辨证及方剂整理证型pattern sClinicalGynecologicalDiseases妇科特征SignsandSymptoms全身证候Tongue舌 象Pulse脉象Acupuncture针灸穴位Herbalformulas常用方剂Kidney肾1.KidneyQiDefi ciency肾气虚Irregularmenstrualcycles,delayedmenstruationwithva riablemenstrualbloodflow,scantyperiodflowthatislightred incolor,floodingandspotting(崩漏),amenorrhea(ā?men??rē?),thr eatened(先兆流产)orrecurrentmiscarriage(复发性流产),infertility,prola pseofuterus,anddifficultdelivery(难产)经行先后不定期,经行后期,量或多或少,经量过少, 经色淡红,崩漏,经闭,胎动不安,滑胎,不孕,阴挺,难产Achinglowerbackandweaklowerlimbs ,vertigo,tinnitus,frequenturination,listlessness,sallowcomp lexion腰酸腿软,头晕耳鸣,小便频数,精神不振,面色晦黯light-redtonguewiththinwhiteco ating舌淡红,苔薄白deep,thready,weakpulse沉细UB23腎腧,GV4命門,CV4關元,KD 3太溪,UB52志室,LU7列缺,KD6照海,CV17膻中,KD7復溜KidneyYangDeficien cy肾阳虚:金匮肾气丸Jinguishenqiwan;艾附暖宫丸aifunuangongwan,右归丸yougu iwan,桂附地黄丸guifudihuangwanSpleen&KidneyYangdeficiency+diar rhea脾肾阳虚泄泻:四神丸Sishenwan;Kidneyyangdeficiency+swollenlowerl imbs肾阳虚水肿:真武汤zhenwutang,八味肾气丸baweishenqiwanKidneyyangdefi ciency+numbinlowerlimbs肾阳虚下肢麻:肾阳虚下肢麻丸shenyangxuxiazhima wan。Kidneyyangdeficiency+colddampinthelowerlimbs肾阳虚下肢寒湿:独 活寄生汤duhuojishengwan。肾阳虚尿频:肾阳虚尿频丸Kidneyyangdeficiency+infer tility肾阳虚不孕不育:毓麟珠丸yulinzhuwan五子衍宗丸加淫羊藿肉桂wuziyanzongwan。肾阳虚 但上火:巴戟天肉苁蓉丸Kidneyqideficiency(habitualabortion)肾气虚滑胎,流产:寿胎丸sh outaiwan2.KidneyYangDeficiency肾阳虚Menstrualdiarrhea,vaginal dischargethatisclearandthinintexture,gestational(妊娠期)ede ma,infertility,floodingandspotting(崩漏),andthreatenedmiscar riage经行泄泻,带下量多、清稀,子肿,不孕,崩漏,胎动不安Achinglowerbackandweak&coldl owerlimbs,severelumbarpain,tinnitus(tin?d?s),clearcopious urine,nocturia([n?k`tju?ri?]夜尿症),lowlibido,listlessness,diarr hea,edema腰酸腿软,甚至腰痛如折,头晕耳鸣,畏寒肢冷,小便清长,夜尿多,性欲减退,精神萎靡,泄泻,水肿paleton guewiththin,white,andmoisttonguecoating舌淡,苔薄白而润deep,threa dorslow,deep,andweakpulse沉细而迟,或沉弱UB23腎腧,GV4關元,CV4命門,CV6 氣海,KD3太溪,KD7復溜,UB52志室,UB13肺俞,UB22三焦俞,ST28水道,SP9陰陵泉,LU 7列缺3.KidneyYinDeficiency肾阴虚Earlyordelayedmenstruation,sca ntyinamountandbrightredincolor,amenorrhea,floodingands potting(崩漏),perimenopausalsyndrome(围绝经期综合征),threatenedmiscarr iageandinfertility经行后期或先期,经血量少、色鲜红,经闭,崩漏,经断前后诸证,胎动不安,不孕Achingl owerbackandweaklowerlimbs,vertigo,tinnitus(tin?d?s),drym outhandthroat,malarflush(/?mɑ?l?r/颧红),feverishfeelinginpa lmsandsoles,insomnia,nightsweats.腰酸腿软,头晕耳鸣,口燥咽干,颧红,手足心热,失眠盗汗 redanddrytongue,scantyornotonguecoating舌红而干,少苔或无苔,或花剥thre ady,fastpulse,weakpulseatchi(cubit)region细数,尺脉无力KD3太溪,KD 6照海,LU7列缺,SP6三陰交,CV4关元,KD10陰谷KidneyYindeficiency肾阴虚:六味 地黄丸liuweidihuangwan,两地汤加二至丸,左归丸zuoguiwanhyperactivityoffi reduetodeficiencyofkidneyyin肾阴虚火旺:大补阴丸dabuyinwan,知柏地黄丸zh ibaidihuangwan,Heart&KidneyYinDeficiency心肾阴虚:黄连阿胶汤huanglia nejiaotang,Kidneyyindeficiency+infertility肾阴虚不孕:养精种玉丸yang jingZhongyuwanLiver肝1.LiverQiStagnation(BindingConstrainto fLiverQi)肝气郁结Irregularmenstrualcyclewithvaryingamountofb lood,darkredincolor,inhibitedflowofmenstrualblood,dysme norrhea,amenorrhea,premenstrualsyndrome,infertility,anddiffi cultieswithbreastfeeding经行先后无定期,经量多少不定、血色暗红,经行不畅,痛经,经闭,不孕,缺乳Di stendingpaininthehypochondriumandthebreasts,chest,poora ppetite,belching,tightnessanddiscomfort,lowerabdominaldist endingpain,frequentsighing,poorappetite,胸胁乳房胀痛,胸闷不舒,小腹胀痛,时欲太 息,嗳气,食欲不振normaltonguewiththin,whitetonguecoating舌正常,苔薄白wir ypulse弦LIV-3(太沖),GB-34(陽陵泉),LIV-13(章門),LIV-14(期門),SJ-6(支溝), P-6(內關)LVQiStagnation肝郁气滞:柴胡疏肝散chaihushugansanLVQiStagna tion+spleenqideficiency肝郁脾虚:逍遥丸xiaoyaosanLiverconstraint,bl ooddeficiency,infertility肝郁血虚不孕:调经种玉汤Liverconstraint,spleendef iciency,infertility肝郁脾虚不孕:开郁种玉汤2.LiverConstraintTransformingIn toFire肝郁化火Earlyperiodprofuseinamountandpurple-redincolor ,floodingandspotting(崩漏),menstrualhematemesis(hēm??tem?s?s吐血 )andepistaxis(?ep??staks?s鼻衄),morningsickness.经行先期,量多、色紫红,崩漏, 经行吐衄,妊娠恶阻Headache,vertigo,tinnitus(tin?d?s),redandswellinge yes,bittertasteinmouthwiththirst,anxiety,irritation,hypoc hondriacpain头痛,眩晕,耳鸣,目赤肿痛,口苦而干,烦躁易怒,胁痛redtonguewiththin,yell owishtonguecoating舌红.苔薄黄wiry,fastpulse弦数LIV-3(太沖),GB-34(陽陵泉 ),LIV-13(章門),LIV-14(期門),SJ-6(支溝),LIV-2(行間),GB-20(風池),TaiY ang(太陽),GB13(本神)丹栀逍遥丸,Danzhixiaoyaowan3.Damp-heatinthe LiverChannel肝经湿热Yelloworredleukorrhea(lo?ok??rē?)withafou lsmell,vulvar(外阴)itching,andvulvar[''v?lvi?]erosion带下色黄或赤、臭 秽,阴痒,阴蚀Chesttightness,hypochondriacpain,anxiety,irritation,d rystool,darkurine,bittertasteinthemouth,drythroat胸闷胁痛,心 烦易怒,大便干燥,小便黄赤,口苦咽干redtonguewithyellow,slimycoating舌红,苔黄腻wir y,slippery,fastpulse.弦滑而数LIV-14(期門),GB-24(日月),GB-34(陽陵泉),UB -18(肝俞),UB-19(膽俞),DU-9(至陽),REN-12(中脘),SP-9(陰陵泉),SP-6(三陰交),S P-3(太白),LI-11(曲池),LIV-2(行間)LiverFire+constipation肝火便秘:泻青丸xi eqingwanDampHeatintheLV&GB肝胆湿热:龙胆泻肝丸longdanxieganwan, 金铃子散,jinlingzisan4.AscendantHyperactivityofLiverYang肝阳上亢Pe rimenopausalsyndromes,vertigoduringpregnancy经断前后诸证,妊娠眩晕Vertig o,headache,fuzzyvision,deafness,tinnitus,limbnumbness,trem bling,insomnia,Excessivedreaming,feverishfeelinginpalmsa ndsoles头晕头痛,目眩,耳聋,耳鸣,四肢麻木、震颤,少寐多梦,手足心热redtonguewithscantyto nguecoating舌红,苔少wiry,threadyorwiry,vigorouspulse弦细或弦而有力LIV- 3(太沖),SJ-5(外關),SP-6(三陰交),KID-3(太溪),LIV-8(曲泉),GB43(俠溪),GB3 8(陽輔),UB-2(攢竹),TaiYang(太陽),GB-20(風池),GB-9(天沖),GB-8(帥谷),GB-6 (懸釐)天麻钩藤饮Tianmagoutengyin5.InternalStirringofLiverWind肝风 内动PregnancyEpilepsy,postpartumconvulsion.妊娠瘸证,产后发痉Headache,ve rtigo,fuzzyvision,suddensyncope,unconsciousnesslimb,convu lsions,opisthotonos/??p?s?θ?t(?)n?s/头痛头晕,眼花,突然昏厥,不省人事,手足抽搐,角弓反 张redorcrimsontongue,exfoliatedorhasnocoating舌红或绛,无苔或花剥wiry ,thready,fastpulse弦细而数LIV-2(行間),LIV-3(太沖),GV16(风府),GB20(风池 ),Du20(百会),SI3(后溪)withUB62(申脉)Liver&Kidneyyindeficiency肝肾 阴虚,肝风内动:镇肝熄风汤zhenganxifengtangSpleen脾1.SpleenQiDeficiency脾 气虚Earlyperiod,menorrhagia月经过多men??rāj(ē)?withbloodoflight color,floodingandspotting(崩漏),amenorrhea,leukorrheaanduter ineprolapse.经行先期,月经过多、血色淡,崩漏,经闭,带下,阴挺Yellowishcomplexion,limb lassitude,ablandtasteinmouth,noappetite,abdominaldistenti on面色淡黄,四肢倦怠,无力,口淡乏味,不思饮食,食后腹胀paletonguewiththin,whitetongue coating舌淡,苔薄白moderateandweakpulse缓弱REN-12(中脘),ST-36(足三里),SP -3(太白),SP-6(三陰交),UB-20(脾俞),UB-21(胃俞)SpleenQiDeficiency脾气虚: 四君子汤sijunzitang,SpleenQiDeficiency+Cold-Damp脾虚+寒湿:参苓白术散shen lingbaishusan,六君子汤liujunzitang,香砂养胃丸xiangshayangweiwan ,floodingandspotting崩漏:固崩止带汤gubenzhibengtang,固冲汤guchongta ng2.SpleenYangDeficiency脾阳虚Menstrualdiarrhea,leukorrhea,gest ational妊娠期edema,infertility,delayedmenstruation,amenorrhea, andmorningsickness经行泄泻,带下,子肿,不孕,经行后期,闭经,恶阻Brightwhitecomplexi on,lassitude,fearofcold,coldorswollenlimbs,poorappetite ,abdominaldistentionandfullness,loosestools,obesity,palpi tations,shortnessofbreath面色觥白,倦怠无力,畏寒肢冷,甚则浮肿,食欲不振,腹部胀满,大便溏泄,形体 肥胖,心悸气短enlargedpale,tendertonguewithwhite,slimytonguecoat ing舌淡,胖嫩,苔白腻slippery,moderateorslippery,forcelesspulse缓滑无力或滑 SP-9(陰陵泉),REN-9(水分),ST-28(水道),UB-22(三焦俞)SpleenandStomachde ficiencycold脾胃虚寒:理中丸liZhongwan,Spleenyangdeficiency脾阳虚:黄芪建中汤 huangqijianzhongtang,健脾丸jianpiwan,附子理中丸fuzilizhongwan,S pleen&kidneyYangdeficiency脾肾阳虚:四神丸sishenwan,spleendeficien cy+phlegmretention脾阳不足之痰饮:苓桂术甘汤lingguizhugantang,Spleenyang deficiency+constipation脾阳虚便秘:温脾汤wenpitang,Bleedingdeficiency duetoYangdeficiency,阳虚止血:胶艾四物汤Spleenblooddeficiency,habitu alabortion脾血虚,滑胎,流产:泰山磐石散taishanpanshisan3.phlegmdampness痰湿 Irregularperiod,Delayedmenstrualcycle,ScantyperiodAmenorrhe a,Mid-cyclepain,IncreasedVaginaldischargeLongterminfertilit y妇人体肥痰盛,子宫脂满,不能孕育者。多囊、形盛多痰,气虚,至数月而经始行;形肥痰盛经闭;肥人气虚生痰多下白带。经水逐渐减少,以致 经闭。Shortnessofbreath,Epigastricfullness,LassitudeoflimbsPr ofusesputuminthethroat,Obesity,Dizziness,Nausea,Adhesions ,Generalfeelingofheaviness形体日渐肥胖,腰酸浮肿,胸闷恶心,心悸气短,纳谷少馨,乏力倦怠。瘰疠痰 核或肿或痛Paleandplumptonguewhiteandgreasytonguecoating舌苔白腻Sli ppery脉滑ST40(豐隆)、Ren12(中脘)、ST36(足三里)、SP9(陰陵泉)Infertilityduetop hlegmdamp痰湿不孕:启宫丸qigongwan,苍附导痰汤cangfudaotantangcrewels瘰 疠:内消瘰疠丸neixiaoluoliwanConcurrentPatterns1.DeficiencyofBoth theHeartandSpleen心脾两虚Delayedmenstruation,scantyinamount, amenorrhea,threatenedabortion,earlyperiod,floodingandspott ing(崩漏),andvisceral/?v?s(?)r(?)l/agitation月经后期,量少,闭经,胎动不安,月经先 期,崩漏,脏躁Sallowcomplexion,vertigo,palpitations,Amnesia[?m?ni:? ?]健忘症,littlesleepandexcessivedreaming,mentalfatigue,limb lassitude面色萎黄,头晕心悸,怔忡健忘,少寐多梦,神疲肢倦lightredtonguewiththin,whit etonguecoating舌淡红,苔薄白thready,weakpulse细弱HT-7(神門),PC-6(內關), REN-14(巨闕),REN-15(鳩尾),REN-4(關元),UB-17(膈俞),UB-20(脾俞)REN-12(中 脘),ST-36(足三里),SP-3(太白),SP-6(三陰交),UB-20(脾俞),UB-21(胃俞)Hearta ndSpleenDeficiency心脾血虚:归脾丸guipiwan,2.Non-InteractionBetween theHeartandtheKidney心肾不交Perimenopausalsyndrome,andvisceral /?v?s(?)r(?)l/agitation经断前后诸证,脏躁Severepalpitations,amnesia健忘症 ,deficiencyandvexation,excessivedreaming,vertigo,tinnitus, achinglowerbackandweaklowerlimbs怔忡,健忘,虚烦,多梦,头晕耳鸣,腰酸腿软redt onguewithnoorthintonguecoating舌红,苔薄或无苔thready,fastpulse, weakinthechi(cubit)region细数,两尺无力HT-9(少衝),HT-8(少府),HT-7(神門) ,REN-15(鳩尾),SP-6(三陰交),KI-6(照海)UB23腎腧,GV4命門,CV4關元,KD3太溪,U B52志室,LU7列缺,KD6照海,CV17膻中,KD7復溜Heartfire+kidneyyangde ficiency心火,肾阳虚:交泰丸Jiaotaiwan,附子泻心汤FuzixiexintangHeartfire +KidneyYindeficiency:黄连阿胶汤Huanglianejiaotang3.Liver-Kidney YinDeficiency肝肾阴虚Floodingandspotting(崩漏),vertigoduringpregnancy,visceral/?v?s(?)r(?)l/agitation,andpruritus[pr??ra?t?s]vulvae[?v?lv?]崩漏,妊娠眩晕,脏躁,阴痒Presenceofsymptomsandsignsofboth"kidneyyindeficiency"And"ascendanthyperactivityofliveryang"“肾阴虚”与“肝阳上亢”二型之合证redanddrytongue舌红而干wiry,thready,andfastpulse弦细而数LV8曲泉,SP6三阴交,LV3太冲,KI3太溪,KD6照海,LU7列缺,SP6三陰交,CV4关元,KD10陰谷Liver&Kidneyyindeficiency肝肾阴虚,肝风内动:镇肝熄风汤zhenganxifengtang4.Spleen-KidneyYangDeficiency脾肾阳虚Menstrualdiarrhea,leukorrhea,andgestationaledema经行泄泻,带下,子肿Presenceofsignsandsymptomsofboth"kidneyyangdeficiencyand"spleenyangdeficiency"“肾阳虚”与“脾阳虚”二型之合证paletonguewithwhitemoistenedorslimytonguecoating舌淡,苔白洞或腻deep,slowordeep,weakpulse沉迟或沉弱SP-9(陰陵泉),REN-9(水分),ST-28(水道),UB-22(三陰交),SP-3(太白)UB23腎腧,REN4關元,DU4命門,REN6氣海,KD3太溪,KD7復溜,UB52志室,UB13,UB22三焦俞,ST28水道,SP9陰陵泉,LU7列缺Spleen&KidneyYangdeficiency+diarrhea脾肾阳虚泄泻:四神丸sishenwan;无比山药丸wubishanyaowanKidneyyangdeficiency+swollenlowerlimbs肾阳虚水肿:真武汤 |
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